VA Center for Clinical Management Research, VA Ann Arbor Healthcare System, 2800 Plymouth Rd. Building 16, Floor 3, (152), Ann Arbor, MI, 48105, USA.
Healthcare Delivery Institute, Intermountain Healthcare, 5026 South State Street, 3rd Floor, Murray, UT, 84107, USA.
Healthc (Amst). 2021 Jun;8 Suppl 1(Suppl 1):100455. doi: 10.1016/j.hjdsi.2020.100455.
Traditional research approaches do not promote timely implementation of evidence-based innovations (EBIs) to benefit patients. Embedding research within health systems can accelerate EBI implementation by blending rigorous methods with practical considerations in real-world settings. A state-of-the-art (SOTA) conference was convened in February 2019 with five workgroups that addressed five facets of embedded research and its potential to impact healthcare. This article reports on results from the workgroup focused on how embedded research programs can be implemented into heath systems for greatest impact.
Based on a pre-conference survey, participants indicating interest in accelerating implementation were invited to participate in the SOTA workgroup. Workgroup participants (N = 26) developed recommendations using consensus-building methods. Ideas were grouped by thematic clusters and voted on to identify top recommendations. A summary was presented to the full SOTA membership. Following the conference, the workgroup facilitators (LJD, CDH, NR) summarized workgroup findings, member-checked with workgroup members, and were used to develop recommendations.
The workgroup developed 12 recommendations to optimize impact of embedded researchers within health systems. The group highlighted the tension between "ROI vs. R01" goals-where health systems focus on achieving return on their investments (ROI) while embedded researchers focus on obtaining research funding (R01). Recommendations are targeted to three key stakeholder groups: researchers, funders, and health systems. Consensus for an ideal foundation to support optimal embedded research is one that (1) maximizes learning; (2) aligns goals across all 3 stakeholders; and (3) implements EBIs in a consistent and timely fashion.
Four cases illustrate a variety of ways that embedded research can be structured and conducted within systems, by demonstrating key embedded research values to enable collaborations with academic affiliates to generate actionable knowledge and meaningfully accelerate implementation of EBIs to benefit patients.
Embedded research approaches have potential for transforming health systems and impacting patient health. Accelerating embedded research should be a focused priority for funding agencies to maximize a collective return on investment.
传统的研究方法不能及时推广循证创新(EBIs)以造福患者。将研究嵌入卫生系统可以通过将严格的方法与现实环境中的实际考虑相结合,加速 EBI 的实施。2019 年 2 月召开了一次最新进展(SOTA)会议,有五个工作组解决了嵌入研究及其对医疗保健影响的五个方面。本文报告了专注于如何将嵌入研究计划纳入卫生系统以产生最大影响的工作组的结果。
根据会前调查,邀请对加速实施感兴趣的参与者参加 SOTA 工作组。工作组参与者(N=26)使用建立共识的方法制定建议。想法按主题集群分组并进行投票,以确定最佳建议。总结报告提交给 SOTA 全体成员。会议结束后,工作组主持人(LJD、CDH、NR)总结了工作组的发现,与工作组成员进行了成员检查,并用于制定建议。
工作组制定了 12 项建议,以优化嵌入研究人员在卫生系统中的影响力。该小组强调了“投资回报率(ROI)与 R01 目标”之间的紧张关系——卫生系统关注实现投资回报(ROI),而嵌入研究人员关注获得研究资金(R01)。建议针对三个主要利益相关者群体:研究人员、资助者和卫生系统。支持最佳嵌入式研究的理想基础是一个可以(1)最大化学习;(2)在所有 3 个利益相关者之间协调目标;(3)以一致和及时的方式实施 EBI。
四个案例通过展示关键的嵌入式研究价值,展示了嵌入式研究在系统内构建和进行的各种方式,使与学术附属机构的合作能够产生可操作的知识,并有效地加速实施 EBI 以造福患者。
嵌入式研究方法有可能改变卫生系统并影响患者健康。加速嵌入式研究应成为资助机构的重点优先事项,以最大限度地提高投资回报。